Summary
Buruli ulcer is a skin infection that affects the subcutaneous tissue and sometimes the bone. It is caused by a pathogen called Mycobacterium ulcerans. The mode of transmission is still unknown but they have an idea that it’s from contaminated water. Buruli ulcers have been found in 33 countries, but most common in tropical and subtropical regions. Statistics show that Buruli ulcer’s effect mostly kids under the age of 15 years old. It starts off as a painless swelling usually on the limbs and becomes an ulcer within 4 weeks creating abnormal deformities. Buruli ulcers are the third most common mycobacterial disease.
Fact Table
| Formal binomial name of microbe: | Mycobacterium ulcerans |
| Gram stain (gram positive, gram negative or neither): | Gram positive |
| Is the microbe mobile or immobile? | mobile |
| Primary habitat? (Where is the organism normally found or prefer to live?) | A temperature of 29-33 degrees Celsius and a 2.5% oxygen concentration level |
| Can the organism infect humans? | Yes |
| Can the organism infect other species? If so, which ones. | Yes, mammals such as goats, possums koalas, and dogs |
| Documented cases of antimicrobial resistance? | Rifampicin and streptomycin should always be given together to avoid resistance |
| Number of infections per year in the US | Not very many since the United States isn’t tropical |
| Number of infections per year in the world | Up to 2,713 cases in 2018 that were reported |
Description
Buruli ulcer’s usually begins with a lump under the skin and grows into an ulcer where the lump is. Mycobacterium ulcerans, the bacteria that causes Buruli ulcer, produces a toxin called mycolactone. Mycolactone eventually leads to tissue/cell death. Buruli ulcers are cauterized into 3 categories. The treatments depend on what category the ulcer falls into. Category 1 is a single, small lesion smaller than 5cm. Category 2 is a single, large ulcerative lesion that ranges from 5-15cm. Category 3 is multiple lesions and osteomyelitis that is normally bigger than 15cm. Below, the images show what the ulcers look like in each category.
Lesions occur Since the mode of transmission is still unknown, unfortunately, there is no way to prevent Buruli ulcers. They are mainly found in Africa but 33 countries have been impacted, especially in the tropical areas. In Africa, about 50% of those affected are children under the age 15 that have little access to the healthcare system. Studies have shown that 25% of cases have been reported late. If not treated early enough long term disabilities can occur such as deformities, amputation to limbs, and muscle contractions. Antibiotics that treat these ulcers are Rifampicin and streptomycin. Rifampicin is taken by mouth daily for 8 weeks and streptomycin is taken daily by injection for 8 weeks. Antibiotics for pregnant women are rifampicin and clarithromycin.
News Articles
Studies have shown that mosquitoes are not a mode of transmission of this disease. Multiple mosquitoes were collected over the course of a year in an area where Buruli ulcers were most popular. None of those mosquitoes carried the DNA of Mycobacterium ulcerans bacteria.
“New report says mosquitoes ‘don’t play pivotal role’ in Buruli spread”
The bacteria, Mycobacterium ulcerans, that causes Buruli ulcers are spreading in Australia and scientists don’t know why. In 2016, Buruli ulcers were the highest ever reported with 182 new cases in a specific area. Scientists still don’t know anything about this disease except that it is associated with wet and tropical areas
“What We Know About the Mysterious Flesh-Eating Bacteria Spreading in Australia”
Researchers have found that a tuberculosis drug development is more effective than the current antibiotics for these ulcers. Scientists are now working to find a new heat therapy as an alternative treatment and a rapid diagnostics test for Buruli ulcers.
“Buruli ulcer: Promising new drug candidate against a forgotten disease”
Reference List
“Buruli Ulcer(Mycobacterium ulcerans infection)”;World Health Organization;
https://www.who.int/news-room/fact-sheets/detail/buruli-ulcer-(mycobacterium-ulcerans-infection)
“Buruli Ulcer”;Science Direct;
https://www.sciencedirect.com/topics/medicine-and-dentistry/buruli-ulcer
“Treatment of Mycobacterium ulcerans Disease(Buruli Ulcer)”;World Health Organization;
https://www.afro.who.int/sites/default/files/2017-06/9789241503402_eng.pdf